[Nosocomial bloodstream infections caused by gram-negative bacilli: epidemiology and risk factors for mortality].
Nosocomial bacteremia is a major cause of hospital infection, associated with high rate of morbidity and mortality, prolonged hospital stay and higher costs. However, few prospective studies analyse the prognostic factors associated with mortality of gramnegative rods bloodstream infections in hospital wards outside of intensive care units. A prospective/descriptive study was conducted from March to December 2006. All patients with nosocomial-acquired bloodstream infection due to gramnegative rods were included. Epidemiology and clinical features were analysed as potential prognostic factors for mortality. During the study period, 84 cases were detected, being A. baumannii, Burkholderia sp and E. coli the most frequent isolates, with a mortality of 48%>. Bacteremia derived from a high-mortality associated septic focus (RR 4.9, IC95%> 1.3 - 18.8) and admission to intensive care unit (RR 4.78, IC95%> 1.7- 13.1) were independent variables associated with mortality. Inappropriate empirical antibiotic treatment was not associated with greater risk of mortality. Nosocomial gramnegative bloodstream infections in our series were mainly due to non-fermentative bacilli and were associated with high mortality rates when their origin was a high risk septic focus or the patient was admitted to intensive care unit.
Lizaso
Diego
D
Servicio de Infectología, Hospital Interzonal de Agudos San Martín, Buenos Aires, Argentina. diegolizaso@yahoo.com.ar
Aguilera C
Karina
K
Correa
Malena
M
Yantorno
María Laura
ML
Cuitiño
Mario
M
Pérez
Lorena
L
Lares
Mónica
M
Parra
Gloria de la
Gde L
Esposto
Amadeo
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult